Management of Zinc Phosphide Ingestion

Immediate Management Protocol

• The American Heart Association guidelines recommend contacting the Poison Control Center immediately for specific guidance on zinc phosphide toxicity management, and activating EMS for potential rapid deterioration 1, 2
• The American Heart Association guidelines do not recommend administering anything by mouth, including via gastric lavage, unless specifically directed by poison control 1, 2
• Do not induce vomiting or administer ipecac, as this is contraindicated and provides no clinical benefit while potentially causing harm through aspiration of phosphine gas 1, 2
• Do not administer water or milk for dilution, as no human studies demonstrate clinical benefit and administration may cause emesis and aspiration of toxic phosphine gas 1, 2
• Do not delay EMS activation while attempting home interventions 2

Appropriate Decontamination Strategy

• Activated charcoal (1 g/kg) via small-bore nasogastric tube may be administered if specifically recommended by poison control, though evidence for efficacy in zinc phosphide poisoning is limited 3